Toscano Manuel, Cristina Sérgio, Alves Ana Rafaela
Internal Medicine, Hospital de Cascais, Cascais, PRT.
Cureus. 2020 Feb 19;12(2):e7042. doi: 10.7759/cureus.7042.
Syncope is a common complaint among patients presenting to the emergency department. Its differential diagnosis is broad and its management varies significantly depending on the underlying etiology. This is especially complex in patients with head and neck cancer since it may appear as an initial manifestation of the disease, as a side effect of surgery or radiotherapy, or as an indicator of local recurrence. Carotid sinus syndrome is a rare disease, whose pathophysiology is not yet fully understood. Here, we present the rare case of a 79-year-old male patient with a left cervical lymph node metastasis from an occult primary malignancy, who was admitted due to recurrent syncope. Paroxysms of extreme bradycardia were detected and a definitive dual chamber pacemaker was placed; however, the patient remained symptomatic. Cervical CT-scan revealed incarceration and compression of the left carotid sinus. The patient underwent radiotherapy, with favourable response, and remains asymptomatic to date.
晕厥是急诊科患者的常见主诉。其鉴别诊断范围广泛，治疗方法因潜在病因的不同而有显著差异。对于头颈癌患者而言，情况尤为复杂，因为晕厥可能是疾病的首发表现、手术或放疗的副作用，或者是局部复发的指标。颈动脉窦综合征是一种罕见疾病，其病理生理学尚未完全明确。在此，我们报告一例罕见病例，一名79岁男性患者，因隐匿性原发性恶性肿瘤出现左颈淋巴结转移，因反复晕厥入院。检测到阵发性极度心动过缓，并植入了双腔起搏器；然而，患者仍有症状。颈部CT扫描显示左颈动脉窦受压并被包绕。患者接受了放疗，反应良好，至今无症状。
